Management of dyslipidemia in adults. Am Fam Physician 1998 May 01;57(9):2192-2204, 2207-8
Date
06/02/1998Pubmed ID
9606309Scopus ID
2-s2.0-0032080052 (requires institutional sign-in at Scopus site) 54 CitationsAbstract
The importance of treating dyslipidemias based on cardiovascular risk factors is highlighted by the National Cholesterol Education Program guidelines. The first step in evaluation is to exclude secondary causes of hyperlipidemia. Assessment of the patient's risk for coronary heart disease helps determine which treatment should be initiated and how often lipid analysis should be performed. For primary prevention of coronary heart disease, the treatment goal is to achieve a low-density lipoprotein (LDL) cholesterol level of less than 160 mg per dL (4.15 mmol per L) in patients with only one risk factor. The target LDL level in patients with two or more risk factors is 130 mg per dL (3.35 mmol per L) or less. For patients with documented coronary heart disease, the LDL cholesterol level should be reduced to less than 100 mg per dL (2.60 mmol per L). A step II diet, in which the total fat content is less than 30 percent of total calories and saturated fat is 8 to 10 percent of total calories, may help reduce LDL cholesterol levels to the target range in some patients. A high-fiber diet is also therapeutic. The most commonly used options for pharmacologic treatment of dyslipidemia include bile acid-binding resins, HMG-CoA reductase inhibitors, nicotinic acid and fibric acid derivatives. Other possibilities in selected cases are estrogen replacement therapy, plasmapheresis and even surgery in severe, refractory cases.
Author List
Ahmed SM, Clasen ME, Donnelly JEMESH terms used to index this publication - Major topics in bold
AdultCholesterol
Cholesterol, HDL
Cholesterol, LDL
Coronary Disease
Dietary Fats
Dietary Fiber
Drug Therapy, Combination
Humans
Hyperlipidemias
Hypolipidemic Agents
Life Style
Middle Aged
Patient Education as Topic
Risk Factors
Teaching Materials
